What to Expect from 28-31 Weeks
Depending on how sick your baby is, she may not show the expected age-appropriate behavior until she’s feeling better.
Before Your Baby is Born
- Your baby is gaining weight.
- Body muscle and fat are increasing.
- Your baby's eyes open and close.
- Your baby's bones are fully developed but are soft and flexible.
All babies have red skin color, despite ethnic background. Natural skin color will develop over the next four weeks. Your child's ears are very soft and bend easily. You’ll see soft, fine hair that covers your baby's body. In some areas it may be very dark. This is called lanugo.
Tone and Posture
Your baby's muscle tone is improving, and his arms and legs are slightly bent. The muscles in the legs will develop strength first. Your baby will try to pull his legs up toward his stomach. Always remember that your baby's head will fall back unless it’s supported.
Your baby's nerves are not fully developed, and movements are not smooth. You may notice shaky or jerky movements. Your baby is able to open and close her hands, and can maintain a grip for a short period of time. For the first time, planned movement is seen. This will happen in her legs.
Your baby will blink, or close his eyes tightly when exposed to light. He’ll have poor control of eye movements. Expect them to be jerky, and for his eyes to appear crossed. By 29 weeks, he may be able to focus on an object and follow it.
Your baby is unable to turn her head toward sound, and easily startles with loud noises. These loud noises are stressful, but soothing sounds help calm her. She may stop moving, open her mouth or widen her eyes. She knows the sound of your voice and calms when she hears you speak.
Your baby may be able to suck and swallow, but it will be slow and awkward. This action will make him tired. Swallowing is irregular and the gag reflex is not fully developed, so your baby will still be fed by a tube that goes through his nose to his stomach. He may benefit from non-nutritive sucking at the breast or with a pacifier.
A gentle touch may cause your baby to move and wake up. She may be able to tolerate longer periods of touching without becoming stressed or upset, and may stay awake for several minutes at a time. Painful procedures or stimulation will cause your baby to pull away and cry.
At 28 weeks, your baby sleeps most of the time. As each week passes, the periods of alertness increase. Expect your baby to be able to focus on something for 30 to 60 seconds. Remember that your baby may become upset if he has too much activity.
Things to Do For Your Baby
Learn what normal behavior is for your baby and what causes her to feel stressed. Also learn the cues she gives you when she’s ready to interact. These are called "approach signals." [BOOKMARK]
It’s important to discover the type of touch that soothes and comforts your baby, and to learn how to lay him in comfortable positions like the fetal position. You can help him stay in this position by bringing his legs and arms close to his stomach and chest. Position your baby's hands close to his mouth or face whenever possible.
Also learn how to nest your baby in the isolette. This is called containment. It’s done by loosely wrapping your baby in a blanket and placing rolls completely around her body. This gives her boundaries on all sides and helps her stay in a tucked position. Remember that she needs sleep in order to grow.
Always support your baby's head while you are holding him, touch him with a firm caress rather than soft stroking movements, and shield his eyes from bright lights. You can also hold your baby wrapped in a blanket or skin-to-skin (kangaroo care), have him look at your face, and offer a pacifier during tube feedings if you notice him making sucking movements. Talking or reading to your baby in a low quiet voice for short periods of time is also beneficial.
Once your baby can open her eyes, allow her quiet time to focus. Babies have a hard time handling several things going on at one, such as talking, looking around and being touched. Use only one form of interaction at a time with your baby, like speaking softly, rocking or touching. She can become very tired just trying to focus on you or an object.
Consider bringing in a blanket or afghan from home to cover your baby's isolette. Your baby needs to be in a dark environment when sleeping and have periods of light during awake times.
Approach signals are behaviors that may mean your baby is ready for interaction:
- relaxed arms, legs and facial expressions
- sucking on fingers or hands
- awake and quiet
- bright and shiny eyes
- focused attention (looking).
Time-out signals are behaviors that may mean your baby needs rest:
- change in breathing patterns, heart rate or color
- worried facial expression
- limp posture
- looking away from you
- flailing arms or legs
- tremors or startles
- spreading fingers apart (splaying)
- arching back and neck.